Hypodermic injection

“ I want to add here that should you run out of sterilized gauze at any time you can make it from any soft cloth by boiling it for ten minutes in the bichloride solution and hanging in the air to dry.
The pain attendant upon any surgical manipulation can be prevented by the hypodermic injection of a solution of cocaine. When you get your hypodermic have the instrument man show you how it works. He can show you much better than I can tell it. Insert the needle half an inch from the wound and inject a few drops of the solution into the skin. ”

“ The Dose of Atropia for Subcutaneous Injection.—I wish to answer the query of Dr. Sisson in the Practitioner of last month with every caution, but I have formed a strong opinion on the subject in question. A “Country Practitioner,” who wrote to this journal in February, states that he used to give hypodermic injections of more than 1⁄5 grain of atropia daily, to the same patient, for years. ”

“ Well, Monsieur le Préfet, I maintain that a man who practises medicine with great skill and who is accustomed to treating sick people, as Cosmo Mornington was, is incapable of giving himself a hypodermic injection without first taking every necessary antiseptic precaution. ”

“ Usually, however, the injection can be made without resistance. Blood should be drained from these cases so as to allow as full capillary penetration as possible. When no arterial injection can be made, open the internal jugular and several other large veins, drain blood from them and then inject fluid while the tube is within the vessel. If necessary add a complete hypodermic injection to all parts of the body excepting the face. Give the cavities full treatment. For transportation, govern yourself according to the transportation rules.
Fatty Degeneration of the Arteries. ”

“ Believing that this remark applies even to the employment of the hypodermic injection of morphia in the treatment of mental disease, I venture on this occasion to lay before the Medico-Psychological Association in the half-hour we devote to Clinical Discussion, a brief outline of three successful cases illustrating the treatment by the hypodermic injection of morphia in recent mania, chronic mania, and melancholia respectively. ”

“ As it was quite weak, he decided not to wait for the doctor, and administered a hypodermic injection. The patient grew rapidly worse and died within a few hours. [Pg 198] There was something strange in the last symptoms, and on later attempting to replace the tube of hypodermic tablets into the case, he found to his consternation that he had taken out the wrong tube, and instead of a small dose of digitalis he had given a large dose of hyoscine.
“This case was related to me by the doctor after he read my paper on the Œdipus Complex. ”

“ Many a physician who has used bread pills or other placebos to replace a drug that he did not want the patient to acquire a habit for, has thus been able to allow good effects to go on without interruption, where the stoppage of medicine had previously interfered with the continuance of the good habit that had been formed. Very few physicians have not seen the effect of a hypodermic of pure water when a hypodermic of morphine is demanded, and when the patient would not sleep without having the hypodermic injection. ”

“ It is not once in a thousand times that a dog or a cat is used for inoculation. The act of inoculation is not in itself painful. A small area of the skin is carefully shaved and cleansed, that it may be aseptic, the hypodermic needle is sterilized and the method of hypodermic injection or of vaccination is the same as it is in medical practice. ”

“ When the suffering is very acute and is aggravating the fever, a hypodermic injection of morphine will often greatly relieve and even favor a revulsion of blood toward the skin, but as it tends to suppress the action of both bowels and kidneys it should be avoided unless it seems absolutely necessary, and above all it should not be given by the stomach. ”

“ DR. NATHAN SMITH DAVIS, OF CHICAGO.
The name of Pravaz, the Lyons surgeon, has been perpetuated by the hypodermic syringe which he devised. The employment of suitable drugs in this instrument is the method par excellence for relieving pain. With it drugs can be injected into unconscious patients. Suicides who refuse to swallow emetics can have their stomachs emptied most effectually of their contents by a hypodermatic injection of apomorphine. ”

“ All ordinary medicine failing, on the evening of the second day the house physician determined to treat the case with hypodermic injections of morphia. He gave three injections of fifteen minims of Magendie’s solution, with two hours’ interval between the doses, and finding that no effects of the morphia were apparent at 2 A.M., he gave an injection of twenty minims. When he returned to the ward, at 4 A.M., the patient was dead. The nurse, on being questioned, stated that the patient was “asleep” before the doctor left the ward. The arm in which the puncture had been made was examined by Dr. ”

“ It is usual to give from 1⁄3 to 2⁄3 grain of emetine hydrochloride, dissolved in sterile saline, by hypodermic injection into the subcutaneous tissues. Some now give as high as 1 grain daily for about ten days, but Vedder prefers 1⁄3 grain repeated 3 times daily. In these doses there is practically no nausea.
It was found by Baermann and Heinemann that subcutaneous injections of from 2 to 21⁄2 grains daily caused indisposition and anorexia. The subcutaneous injections are less painful than the intramuscular ones. ”

“ Before taking off the suction syringe after the passage of the needle sweep the point slowly in a circle to make sure that no vein has been opened or is likely to be opened as the needle is swept about.
The hypodermic needle for injection.
A hypodermic needle may be used for an internal ring injection or an injection through the anterior wall of the canal, but in moving it about the operator should watch carefully and not break such needle. If a needle breaks it will be at the shoulder formed by the point of attachment of the shaft of the needle with the butt. ”

“ We need this stimulant badly, but we’ve held him steady while you were gone. You made a quick trip.”
“I thought we would never get back here! We had trouble.”
The doctor took the package and hurried into the room where his patient lay. Frank greeted his mother and sister with a kiss and followed close behind.
[Pg 172]
The doctor made up his mixture for the hypodermic injection, and he and the nurse administered it to Mr. Allen, who lay on the cot breathing slowly, his mouth wide open as if he were trying hard to get as much air as possible. ”

“ The hypodermic use of a two-per-cent solution of cocain, or better Eucain β, can be employed, but the author sees no advantage in it, as the hyperemic engorgement following its use obliterates, to a certain degree, the actual extent of the deformity.
[216]
It is desirable to obtain the best result to have the skin above the part as free as possible. When closely adherent it should be freed by the careful use of a delicate tenotome, inserted at the point where the injection is to be made, the same opening being used for the introduction of the needle of the syringe. ”

“ Aspirating of blood may mean the puncture of this large vein and it may not be advisable to inject carelessly when this vein has been wounded owing to its size. The crural canal is only about a half inch in length. The injection of it may be accomplished with a hypodermic needle. It is not well to sweep the point of the needle externally with too [Pg 52] great freedom as the vein may be wounded. Inject slowly and move the point of the syringe carefully so that the injection may be diffused in the canal. ”

“ The experience of Pasteur, Brown-Sequard, and our own specialists, in the use of extracts of nerve substance and of certain glands and organs by hypodermic or subcutaneous injection of these fluids, has, in a vast number of cases, been most gratifying to both physicians and patients. Many wonderful cures have thus been obtained. Injected subcutaneously these animal extracts are immediately assimilated and we are often able to stop, at once, the progress of disease and turn the tide towards recovery. Thus the cells receive the special stimulants upon which their life and activity depend. ”

“ With some, the injection into external hemorrhoids is quite painful at the first contact of medicine, but immediately thereafter subsides. Where the tumor is very sensitive, external or internal, precede by a hypodermic of from three to five minims of a five per cent. solution of cocaine. Introduce the needle point barely underneath the covering of the growth and force out one drop. ”

“ Furthermore, when paraffin is injected in liquid form, especially when so rendered by a temperature necessarily even higher than the actual melting point, there is danger of searing the entire site intended for injection—a condition inducive to no good and a burning of the skin where the necessary superheated needle enters it, causing a punctate scar, more or less painful during the time required to heal the wound. ”

“ The author advises, when injecting about the neck, to use a stout, dull-pointed needle introduced under local ethyl chloride anesthesia and to elevate the tissue with the needle as the injection is made. In this way the operator can observe the behavior or placing of the injected mass, at the same time stretching the skin to permit of the injection without encroaching upon the blood vessels. The mass is immediately molded after each injection. ”

“ The author has used the cold-injection method in over three hundred nose cases without a single case of sloughing, embolism, or death, and in no case was there secondary diffusion or hyperinjection. The only fault has been the desire on the part of the patient to be finished too quickly, which usually leads to a result not as satisfactory as when the injections are made sufficiently far enough apart to allow the formation of organized tissue at the site of injection. ”

“ He took the needle and made an imaginary lunge at me.
"When people tell you that the hypodermic needle cannot be employed in a case like this that they are planning," he continued, "they are thinking of ordinary hypodermics. Those things wouldn't be very successful usually, anyhow, under such circumstances. But this is different. The very form of this needle makes it particularly effective for anyone who wishes to use it for crime. ”

“ At no time should an injection be crowded into a dense tissue or where the skin is closely adherent, nor carried so far as to create a blanching of the skin. By carefully injecting the mass this danger should be overcome. ”

“ The probability of escaping confinement is a great incentive to a patient to submit to an injection, when he would refuse operation.
Injections are not necessarily unphysiologic as the sufferer from a hernia has a physiologic deficiency which the paraffin accurately fills with normal connective tissue.
The dangers of injection can be eliminated. The technic is not difficult even when all precautions are taken. ”

“ This absorption, following such an injection, is productive of no harm to the human economy, and the new tissue caused to be formed by such injection truly enhances the cosmetic and surgical value of the method inasmuch as an encapsulated mass of paraffin is liable to displacement, spreading, and irregularities, should it be subjected at any time to external violence. ”

“ To assure the operator against such difficulty the needle may be withdrawn after insertion, and if blood does not trickle from the wound it may be reintroduced without pain to the patient and the injection begun.
It is not advisable to correct the defect at one sitting. One third or one half of the depressed area may be overcome by one injection. The resultant tumefaction must then be thoroughly molded out, until little seems to have been accomplished by the injection. ”

“ The moment the hypodermic syringe is taken from the doctor’s or the nurse’s kit, the sufferer is made aware of the means which will be used to give him ease. He remembers it, forming a respect and admiration, almost an affection, for the mere instrument, and with the most intense interest gathers such information as he may find it possible to acquire about this wonder-working little tool and the material which is its ammunition of relief. He knows absolutely that the relief which he has found is not due to medical skill, but to the potency of a special drug administered in a special way. ”

“ These cases, and the effect on myself, taught me, when injecting a patient for the first time, never to give more than the sixth of a grain—wait a quarter of an hour longer, and then give the remainder of the dose, after ascertaining how the first injection was taking effect. Women, I have found, are generally bad subjects for subcutaneous treatment; for they get frightened and nervous—in fact, one woman told me that though the morphia taken by the skin did her more good than by the mouth, yet she preferred the latter, for the instrument frightened her. ”

“ In injecting, the needle should be introduced at a point directly at the root of the furrow or furrows—that is, at the junction of the forehead with the nose.
A needle one inch long should be used, taking care not to puncture any of the veins which are found to be very differently placed in various patients. If blood flows from the needle puncture, no injection should be made at that point, but another be chosen which does not give such result, preferably at a later sitting. ”